Prediction of Postoperative Intraocular Lens Position with Angle-to-Angle Depth Using Anterior Segment Optical Coherence Tomography.
Goto So, Maeda Naoyuki, Koh Shizuka, Ohnuma Kazuhiko, Hayashi Kenichi, Iehisa Ikko, Noda Toru, Nishida Kohji
AI Summary
A new formula using AS-OCT's angle-to-angle depth, preoperative ACD, and axial length more accurately predicted postoperative IOL position than existing methods, potentially improving IOL power calculations.
Abstract
Purpose
To evaluate the accuracy of a new formula for predicting postoperative anterior chamber depth (ACD) with preoperative angle-to-angle (ATA) depth using anterior segment (AS) optical coherence tomography (OCT) and to compare it with established methods.
Design
Retrospective consecutive case series.
Participants
Three hundred four eyes (276 patients) implanted with acrylic intraocular lenses (IOLs) were divided randomly into a training set (152 eyes) and a validation set (152 eyes).
Methods
Based on the training set data, the postoperative ACD measured 1 month after surgery was analyzed via multiple linear regression analysis with 5 preoperatively measured variables: ATA depth, ATA width, preoperative ACD measured with AS OCT, axial length (AL), and corneal power. A new regression formula for predicting postoperative ACD was developed using the results of the stepwise analysis. In the validation set data, the coefficients of determination (R 2 ) between the measured postoperative ACD and the predicted postoperative ACD obtained using the new formula were compared with those obtained using the Sanders-Retzlaff-Kraff theoretic (SRK/T) and Haigis formulas. The absolute prediction errors were compared with each formula.
Main outcome measures
Postoperative ACD, median absolute prediction error of postoperative ACD, and ocular biometric parameters.
Results
In the training set, ATA depth yielded the highest standard partial regression coefficient value, indicating that ATA depth is the most effective parameter for predicting postoperative ACD. The new regression formula was developed with 3 variables; ATA depth, preoperative ACD, and AL. In the validation set, the postoperative ACDs of the new formula, the SRK/T formula, and Haigis formula were predicted with R 2 of 0.71, 0.36, and 0.55, respectively, and the medians of the absolute prediction errors were 0.10 mm, 0.65 mm, and 0.30 mm, respectively. The absolute prediction error with the new formula was significantly smaller than those obtained with the SRK/T and Haigis formulas (P < 0.0001).
Conclusions
The new formula with 3 preoperative parameters-ATA depth, preoperative ACD, and AL-predicted postoperative ACD more accurately than the SRK/T and Haigis formulas. It may be possible to improve the accuracy of IOL power calculation using an improved postoperative ACD prediction with the ATA depth measured by AS OCT.
MeSH Terms
Shields Classification
Key Concepts4
A new regression formula, developed using angle-to-angle (ATA) depth, preoperative anterior chamber depth (ACD), and axial length (AL), predicted postoperative ACD with an R^2 of 0.71 in a validation set of 152 eyes implanted with acrylic intraocular lenses.
The new regression formula, utilizing ATA depth, preoperative ACD, and AL, demonstrated a significantly smaller median absolute prediction error of 0.10 mm for postoperative ACD compared to the SRK/T formula (0.65 mm) and Haigis formula (0.30 mm) in a validation set of 152 eyes (P < 0.0001).
Angle-to-angle (ATA) depth was identified as the most effective parameter for predicting postoperative anterior chamber depth (ACD) based on its highest standard partial regression coefficient value in a training set of 152 eyes implanted with acrylic intraocular lenses.
The accuracy of intraocular lens (IOL) power calculation may be improved by using an enhanced postoperative anterior chamber depth (ACD) prediction that incorporates angle-to-angle (ATA) depth measured by anterior segment optical coherence tomography (AS OCT).
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